Patient information
This medication may cause dizziness, weakness, incoordination,
nausea or vomiting, stomach upset, constipation, headache, drowsiness,
anxiety, irritability, dry mouth, or increased sweating. If any
of these effects persist or worsen, inform your doctor. Notify
your doctor if you develop any of these serious effects while
taking this medication: chest pain, rapid heart rate, skin rash
or itching, mental confusion, disorientation, seizures, tingling
of the hands or feet, trouble breathing. In the unlikely event
you have an allergic reaction to this drug, seek immediate medical
attention. Symptoms of an allergic reaction include: rash, itching,
swelling, dizziness, breathing trouble. If you notice other effects
not listed above, contact your doctor or pharmacist.
Precautions
Tell your doctor your medical history, especially of: kidney disease,
liver disease, seizure disorder, lung disease, history of drug
or alcohol dependency, and any allergies you may have. Limit alcohol
as it may add to the dizziness or drowsiness effects caused by
the medication. Because this drug may make you dizzy/drowsy, use
caution when performing tasks requiring alertness such as driving.
This medication should be used only when clearly needed during
pregnancy. Discuss the risks and benefits with your doctor. Tramadol
is excreted into breast milk. Because the effects on a nursing
infant are not known, consult your doctor before breast- feeding.
Drug interactions
Tell your doctor of all prescription and nonprescription medications
you may use, especially of: carbamazepine, narcotic pain relievers
(e.g., codeine), drugs used to aid sleep, antidepressants (e.g.,
SSRI-types such as fluoxetine or fluvoxamine), MAO inhibitors
(e.g., furazolidone, linezolid, phenelzine, procarbazine, selegiline,
tranylcypromine), psychiatric medicine (e.g., nefazodone), "triptan"-type
drugs, anti-anxiety drugs (e.g., diazepam), sibutramine. Also,
report use of certain antihistamines (e.g., diphenhydramine) that
are also present in many cough-and-cold products. Do not start
or stop any medicine without doctor or pharmacist approval.
Before taking tramadol,
- tell your doctor and pharmacist if you are allergic to tramadol or other narcotic pain medications such as meperidine (Demerol), morphine, codeine (or medications that contain codeine such as Tylenol with Codeine), hydrocodone (e.g., Vicodin), hydromorphone (e.g., Dilaudid), oxycodone (e.g., Percocet), propoxyphene (e.g., Darvon, Darvon N), any other medications, or corn.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: amiodarone (Cordarone, Pacerone); antihistamines; bupropion (Wellbutrin);celecoxib (Celebrex); cimetidine (Tagamet);cyclobenzaprine (Flexeril); digoxin (lanoxin); doxorubincin (Adriamycin);haloperidol (Haldol); imipenem and cilastatin (Primaxin); methadone (Dolophine, Methadose); monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), and tranylcypromine (Parnate); medications for anxiety, mental illness, nausea, pain; medications for seizures, such as carbamazepine (Tegretol); metoclopramide (Reglan); nefazodone; promethazine (Phenergan); quinidine (Quinaglute; Quinidex); ranitidine (Zantac); ritonavir (Norvir, in Kaletra); sedatives; sleeping pills; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); ticlopidine (Ticlid); tranquilizers; tricylic antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil);venlafaxine (Effexor);warfarin (Coumadin). Many other medications may also interact with tramadol, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had seizures, head injury, infection in your brain or nervous system, increased intracranial pressure (increased pressure within the skull), diabetes, breathing problems or lung disease, or kidney or liver disease. Also tell your doctor if you drink or have ever drunk large amounts of alcohol, use or have ever used street drugs, or have overused prescription medications.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking tramadol, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking tramadol.
- you should know that this drug may make you drowsy and may affect your coordination. Do not drive a car or operate machinery until you know how this drug affects you.
- remember that alcohol can add to the drowsiness caused by this drug. The manufacturer states that tramadol should not be taken with alcohol containing beverages.
- you should know that tramadol may cause dizziness, lightheadedness, and fainting when you get up from a lying position. To avoid this, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
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